Diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin, the insulin is of poor quality, or the body cannot use it effectively.
Insulin is a hormone produced by the pancreas. Its main function is to maintain proper blood sugar levels. It allows glucose to enter the body and be transported to the cells, where it is converted into energy for muscles and tissues to function. It also helps cells store glucose until it is needed. People with diabetes have excess blood sugar (hyperglycemia) because it is not properly distributed. Noemí González, secretary of the Spanish Diabetes Association (SED) and specialist in endocrinology and nutrition at the La Paz Hospital in Madrid, explains that high glucose "can be harmful to the whole body, but especially to the heart, kidneys, and arteries." People with untreated or undiagnosed diabetes are at higher risk of kidney problems, heart attacks, vision loss, and lower limb amputations.
Types:
Type 1 Diabetes
This usually occurs in children, but can also start in adolescents and adults. It generally happens suddenly and often, regardless of family history. Autoantibodies destroy the insulin-producing cells in the pancreas (beta cells). "This means the body attacks its own cells as if they were foreign (like in celiac disease and other autoimmune diseases)."
Type 2 Diabetes
Occurs in adulthood, its incidence increases with age, and it is about ten times more common than type 1. In this type, the effect of insulin is diminished, so even though there is plenty of it, it cannot work properly. González states that "there is a mixed component: on the one hand, there is less insulin in the pancreas, and on the other hand, this insulin has a poorer effect on the tissue (insulin resistance)." "The main cause is obesity because adipose tissue produces certain substances that reduce the sensitivity of insulin receptors," adds Ávila. Since obesity has increased significantly in Spain, this type of diabetes has also risen.
Gestational Diabetes: During pregnancy, insulin increases to boost energy reserves. Sometimes, this increase does not happen, leading to gestational diabetes. It usually disappears after childbirth, but these women are at high risk of developing type 2 diabetes later in life.
Symptoms
Possible symptoms of high blood sugar include the following:
- Excessive thirst (polydipsia).
- Feeling very hungry (polyphagia).
- Frequent urination, even at night (polyuria).
- Weight loss despite eating a lot.
- Fatigue.
- Blurred vision.
- Tingling or numbness in hands and feet.
- Recurrent fungal skin infections.
If blood sugar rises gradually (generally in type 2 diabetes), symptoms may take years to appear, making the disease go unnoticed. "Just because it doesn't hurt doesn't mean it isn't damaging, and that’s why early diagnosis is so important to prevent complications," emphasizes González.
Prevention
Currently, type 1 diabetes cannot be prevented despite multiple attempts. Type 2 diabetes, the most common type, can be prevented. Since the most important cause is obesity, "any actions related to obesity prevention — avoiding a sedentary lifestyle, junk food, sugary drinks — will have a positive outcome," emphasizes González, who says "a healthy lifestyle reduces the chances of developing type 2 diabetes by 80%."
Treatments
The treatment of diabetes is based on three pillars: diet, physical exercise, and medication. The goal is to maintain blood sugar levels within normal ranges to minimize the risk of complications associated with the disease. Insulin is the only treatment for type 1 diabetes. Today, it can only be injected, either with insulin pens or continuous infusion systems (insulin pumps). "It is necessary to adjust insulin administration to what the person eats, the activity they do, and their glucose level, so patients often need to measure their glucose with glucose meters (finger pricks) or interstitial glucose sensors (some of which are already covered by various autonomous communities) in a simpler and less painful way," says González. Type 2 diabetes has a broader therapeutic spectrum. In this case, insulin administration is not always necessary, unlike in type 1 patients. A healthy lifestyle and weight loss can normalize glucose levels.
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